Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | CHIRO00891 | GA |
NPI | 1851789291 |
---|---|
Provider Name | Dr. Diana Stephens Albertin |
First Address | Marietta, GA 30067 |
Second Address | Marietta, GA 30067 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2015 |
Last Update Date | 08/01/2015 |